DESIGN: Patients were assessed for food addiction utilizing the Malay YFAS 2.0. The participants were also assessed for eating disorder using the validated Malay Binge Eating Scale. The psychometric properties of the YFAS 2.0 were determined by analysing factor structure, overall item statistics, internal consistency and construct validity.
SETTING: Between 2017 and 2018, participants were chosen from a regional primary-care clinic in the district of Seremban, Malaysia.
PARTICIPANTS: Patients (n 382) from a regional primary-care clinic.
RESULTS: The prevalence of food addiction was 5·0%. A two-factor structure of the YFAS was confirmed as the most optimal solution for the scale via confirmatory factor analysis. In both its diagnostic and symptom count version, the YFAS 2.0 had good internal consistency (Kuder-Richardson α > 0·80 and McDonald's ω > 0·9).
CONCLUSIONS: We validated a psychometrically sound Malay version of the YFAS 2.0 in a primary-care population. Both diagnostic and symptom count versions of the scale had robust psychometric properties. The questionnaire can be used to develop health promotion strategies to detect food addiction tendencies in a general population.
OBJECTIVES:: To test the hypothesis that toe-out gait will reduce second peak knee adduction moment further and increase fall risk when combined with knee brace and laterally wedged insole in knee osteoarthritis patients.
STUDY DESIGN:: Single visit study with repeated measures.
METHODS:: First and second peak knee adduction moments, fall risk and comfort level. First and second peak knee adduction moments were determined from three-dimensional gait analysis, completed under six randomized conditions: (1) natural, (2) knee brace, (3) knee brace + toe-out gait, (4) laterally wedged insole, (5) laterally wedged insole + toe-out gait, and (6) knee brace + laterally wedged insole + toe-out gait. Fall risk was assessed by Biodex Balance System using three randomized stability settings: (1) static, (2) moderate dynamic setting (FR12), and (3) high dynamic setting (FR8).
RESULTS:: The reduction in first peak knee adduction moment and second peak knee adduction moment was greatest (7.16% and 25.55%, respectively) when toe-out gait combine with knee brace and laterally wedged insole. Significant increase in fall risk was observed with knee brace + laterally wedged insole + toe-out gait (42.85%) at FR12. Similar significant balance reductions were found at FR8 condition for knee brace + toe-out gait (35.71%), laterally wedged insole + toe-out gait (28.57%), and knee brace + laterally wedged insole + toe-out gait (50%) as compared to natural. However, knee brace decreased fall risk at FR12 by 28.57%.
CONCLUSION:: There is a synergistic effect of toe-out when combined with knee brace and laterally wedged insole concurrently in second peak knee adduction moment reduction but with a greater degree of fall risk. Simultaneous use of conservative treatments also decreases comfort level.
CLINICAL RELEVANCE: Patients with mild and moderate knee osteoarthritis are usually prescribed conservative treatment techniques. This study will provide an insight whether or not a combination of these techniques have a synergistic effect in reducing knee joint load.
Patients and methods: This study included 50 unilateral transtibial amputees (26 males, 24 females; mean age 55.4±14.7 years; range, 18 to 78 years) who met the respondent criteria of the study. The respondents were randomly selected and were issued with a questionnaire.
Results: The majority of the transtibial amputees were aware of stump contracture complications. It was found that they also preferred methods of prevention which required less effort, was cost-effective, and were also practical.
Conclusion: More focus should be placed on contracture prevention methods which were most complied with by the patients. This is because the effectiveness of a prevention method is highly influenced by patients' compliance with the method. Patients with a higher risk of developing stump contractures should be also given more attention in post-amputation care.
AIM: To assess the level of job satisfaction and perception of Provisionally Registered Pharmacists (PRP) towards the internship training provided.
METHODS: A cross-sectional nationwide survey was conducted amongst all PRPs undergoing training between December 2015 and February 2016 to assess their level of job satisfaction and perception towards the training requirements stipulated by the Pharmacy Board of Malaysia.
RESULTS: A total of 733 PRPs participated in the survey and the response rate was 95.8%. On the basis of the response received, 92.5% (n = 678) felt that the one year training period was 'just nice', 30.5% (n = 223) felt that the logbooks were 'too complicated', and 33.2% (n = 241) said the targets set by the Pharmacy Board of Malaysia were 'too high'. On a scale of 1 to 5, respondents rated 3.32 (SD 0.54) for mean score of job satisfaction. Significant factors influencing mean score of job satisfaction were: perceived fairness at the work place; perceived self-competence after one year of training; preceptors' competence; and pharmacy as a chosen career pathway.
CONCLUSION: Intern pharmacists were fairly satisfied with the internship training in government facilities in the Ministry of Health, Malaysia. A review of the internship logbooks and the practicality of targets set by the Pharmacy Board warrant further improvement.
METHODS/DESIGN: This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score <6) were randomly assigned to the treatment group (MEDIHEALTH) or the control group. The primary outcome of this study is medication adherence level at baseline and 1, 3, 6 and 12 months post-intervention. The secondary outcomes are attitude, subjective norms, perceived behavioural control, intention and knowledge related to medication adherence measured at baseline and 1, 6 and 12 months post-intervention. The effectiveness and sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8.
DISCUSSION: This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program.
TRIAL REGISTRATION: National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706 . Registered on 25 July 2017.
BACKGROUND: Prosthesis should be donned and doffed few times during the day and night; thus, it is important to measure ease of donning and doffing.
STUDY DESIGN: A cross-sectional study.
METHODS: The questionnaire was designed and evaluated by a group of experts. The final questionnaire was administered to 50 individuals with trans-tibial amputation. A test-retest study was also conducted on 20 amputees to assess the repeatability of questionnaire items.
RESULTS: The prosthesis donning and doffing questionnaire was developed and tested through a pilot study. Based on Kappa index, the questionnaire items showed correlation coefficients greater than 0.7, which indicate good reliability and repeatability. The majority of the participants had good hand dexterity (80%) and could perform all types of grasps. The mean satisfaction scores with donning and doffing were 69.9 and 81.4, respectively. Most of the respondents needed to don and doff the prosthesis 3.44 times per day. Based on a 7-point score, the total scores ranged between 3 and 7.
CONCLUSION: The prosthesis donning and doffing questionnaire items showed good psychometric properties. A scoring method was suggested based on the pilot sample, which requires further evaluation to be able to differentiate between more suspension types. A larger international multicenter evaluation is required in the future to measure the responsiveness of the scales. This questionnaire will be useful in the evaluation of the ability of amputees to don and doff a trans-tibial limb prosthesis. Clinical relevance Donning and doffing of prostheses are challenging tasks for many lower limb amputees. The prosthesis donning and doffing questionnaire, on its own or combined with other prosthetic evaluation questionnaires, has the potential to help manufacturers, clinicians, and researchers gain knowledge and improve the donning and doffing qualities of prostheses.
STUDY DESIGN: Prospective study.
METHODS: Looped liners with hook fastener and Iceross Dermo Liner with pin/lock system were mechanically tested using a tensile testing machine in terms of system safety. A total of 10 transtibial amputees participated in this study and were asked to use these two different suspension systems. The pistoning was measured between the liner and socket through a photographic method. Three static axial loading conditions were implemented, namely, 30, 60, and 90 N. Furthermore, subjective feedback was obtained.
RESULTS: Tensile test results showed that both systems could safely tolerate the load applied to the prosthesis during ambulation. Clinical evaluation confirmed extremely low pistoning in both systems (i.e. less than 0.4 cm after adding 90 N traction load to the prosthesis). Subjective feedback also showed satisfaction with both systems. However, less traction at the end of the residual limb was reported while looped liner was used.
CONCLUSION: The looped liner with hook fastener is safe and a good alternative for individuals with transtibial amputation as this system could solve some problems with the current systems. Clinical relevance The looped liner and hook fastener were shown to be good alternative suspension for people with lower limb amputation especially those who have difficulty to use and align the pin/lock systems. This system could safely tolerate centrifugal forces applied to the prosthesis during normal and fast walking.